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Home My WebLink About8092-zl~w~r NO. 4 TOWN OF SOUTHOLD BI~.DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z.7.~30. ..... Date ............ Fe.b .....22 ..... ,19. ~. THIS CERTIFIES that the building located at . Baysknre. Road ........... Street 'Est asmended Map No..Pe.c.~ ~ 1~9 Gl*eenport N,Y, ·. aY.~. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ ,Tu~L~..2¶.., 19 .~[. pursuant to which Building l~ermit No. dated ............ ~..u~.~.....2.2., 1~.~.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .P..r~L.v.a~;e..o~.e.f.~lly..dve~J, lng .v£th. addttl~ .&. Alteration ...... The certificate is issued to . .G.u..s.t.a.v.e...Z.e.l.e..r~..o. ..... . .0J~. er .......................... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval ...N,It, ............................ UNDERWRITERS CERTIFICATE No. ~26~. ~.~ ..... Jan...12...1.976 ............... HOUSE NUMBER .. ~8.~ ....... Street .. ]~ay. shora .Road ........................ FOI~NI NO. 2 TOWH OF eaOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8092 Z Date ................................ ~.U t y. ....... 22., 19.?.%... Permission is hereby granted to: zt ~- ~r~...~L~e..-~p.~.~-.~-..~.';~&g.-...A/.C-.O~ta. ve..-2~ele~1~o box &?6.....~re~n~o~ ............................................... to ..~i.~d...a.~.. ~dd.~. ~. o~.. ~n.. e~-i. ~ .~.i.~.§ - - ~w.e ~.]..i~.~g ............................................................... at premises located at .,.3,oJ;..!~-..~...,.~.,.ZL~,y,.138.~..~q,r~r~ct,ed, .................................................. ........................................................ · :~ a.y ~ k~o ~.~ · · ~.{ o~1. .......... G.~e~n~)]~.~ ......................................... pursuant to application dated ............................ .~....]:~.....~.'{ ......... , 19..:~.~., and approved by the Building Inspector. Fee $...~..~,,~3~ ......... FORM NO. S TOWN OF $OUTHOLD , BuildinB Department Town Clerks Office $outhold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage dispasal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" ';l~nd uses: 1. Accurate survey.of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings." 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New BHilding ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ....... ~.Z~..~.$..b.~..t(..~, .......... .~.f~.. .............. Owner Or Owners Of Property ........... . 'C~...~?~.~...~.~..~ ......... .~.~.~.~3...t..~.~.o..~..~..~. ........................................... Subdivision ................................................................ Lot No...~..~..... Block No ............. ~ House No ............. Permit No. ~.~...c(.~...~-. Date Of Permit ...~./~;~/.7,,.~Applicant ...... .C..~..~)..~/ ........ J?l.~..~..~...~. ............ Health Dept. Approval ............. .~.; ........................... Labor Dept. Approval ..............~..-;; .............................. Underwriters Approval .............................................. Planning Board Approval ........... .~;,-~ .............. Request For Temporary Certificate ........................................ Find Certificate ............... ~ ..................... Fee Submitted $ ..~..:'.~..~/. ................. Sworn to before me this ~ ..c~.~j~... day of ..... ~-~~f ............ ~ (stamp or seal)~~ ~.~. Nota~ Public ........ ~.~/~... Coun~ ~o. 52-8125850, SuffolkCo , Term [~p res ~a~ch 30 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF EI~ECTRICITY '--- dl 85 JOHN STREET. NEW YORK. NEW YORK 10038 'te'" January 12, 1976 '"'"'""'""'""'""/if"820714 N 264533 THIS CERTIFIES THAT Gustave Zelenko, Bayshore Road Kerwin Blvd.&Islands View, Greenport~ L.I. .-~, ,...:i.~,,. January 8p 1976 ri. outside at*d found to be in conspli~nce with the requirement# of (hi~ Board. RXTURE$ ~ANGES Lot OTHRR APPARATUS: DISH WASHERS EXHAUST FANS TIME CLOCKS mMMIRS $ R V I C Elec. room heater/s: 1-1.5kw, 1-.75kw, 1-.5kw i GFI Paul Burns Town Harbor Lane Southold, L.I. 11971 282E ~t This certificate must not be altered in any manner; return to the office of the Board tf incorrect. Inspectors may be their a. This application must be completely filled in by typewriter o~, in ink and ~ubmitted in triplicate to the Building .~( Impector, ~ 3 ~ of plans, accurate pIM plan to Icale. Fee according to .K.~. ule. . ~ b. Plot plan showing location of lot a.nd. of bull. dings on pram'?s,.mlation~ip to. odjo,nin, g. qr?~e~, or..,p~b, hc st.r.e~., o, ~ areas, and giving a detailed description at layout otpraperty must De arawn on me a,agmm .w.n!cn ispa~ of mis app,cofm. ~ c..._TI~/~ covered by this application may nm be commenced before issua..nce o,,f Bu,.Iding Permit: .... r~ d. Upon approval of this application, t+m Building Inspector will issue a Building t-erm,t to the applmant. Sucn permit shall be kept on the premises available for impectton thmnghout the work. e. No building shall be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pu~mnt to the Building Zone Ordinance of the Town of Southold, Suffolk County, New .York, and ?ther al~icable Lov~ Ordl.nan .c~. o,r Regulations, for the construction of buildings, additions or alterations, or for rernoval of demalltlen, .as bemi.n aescn .Dea. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, aha regulatmm, and to admit authorized inspectors on premises and In bulldlngl for necessary inspections. ....................... ............................... (Signature of ppl~llcont, or name, If a corporation) .... ........................ ......... '4.. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................................... ....................................................................................................................................... Name of owner of premises ......... ~[.~1~.~..q..~ ........ .'Z.~..~...~..,[~..~.. .............................................................................. if applicant is a co~oorate, signature of duly authorized officer. (Name and title of coq>orate officer) Builder's License No ........... .~.~..~....-...~.-~ ............... Plumber's License No ................................................. Electrician's License No ........................................ ..... Other Trade's License No ............................................... which praposed work will be dane. Map No.~..~...L...~..--- Lot No....~...~. 1. Location of land on Street and Number ............ B.~..~..~.~t~.[r.~- ........ ~.o.~ ......................................./ / i ................... ~---~.~unf~,,x~ ...... 2. State existing use and occupancy of premises and intended use and occupancy of proposed cortstructlon: I ~'~ ~ ~ ~, . a. Exisitlng use and occupancy ...................... m.d:7......~,....~....LL...:% ............................................................... occ.po. . ......................................................................... b. Intended use and 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................. Repair .................. Removal .................. Demolition..~,,..,~. ......... Other Work ..................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... J[ ................. Number of dwelling units on each floor' ....~ ...................... If garage, number of cars .................................. ; ....... : .................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: F_r:ont ....... ~,,.~;~ ........... Rear ~.~.~..~ ..................... Depth .,.~.~...~. ...... Height ...... L~.....~ ........ Number of Stories J Dimensions of some structure with alterations Or additions: Front ...: ........ ...~...G. ............... Rear ...... ..-~.....~..../. .......... Depth ......... ~..~....~ ............. Height ..:.....~..~...-..;~ ......... Number Of Stories 8':; Dimensions of entire new construction: ~Front ............ i.....'~...~ ........... !.. Rear .......... !...~....~. ........ Depth .....!..~t ............. Height ....l.~. ......... Number ofrStones ........ .( ............................................................................................................ 9. Size of lot: Front ........ ~.: ................................ Rear ........... ~.~1~ ........................ Depth ...... ./..~...~. ................ 10. Date of Purchase ..'. ....... ~ .................................... Name of Former Owner ....................................................... 11. Zone or use district in which premises are situated ..~ ~ 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ...~...~. ......................................... 13. Will lot be regraded'. ........~.'.~..~ ......... Will excess fill be removed from premises: (ZYes ( ) No Name of Architect .............................................................. Address ................................ Phone No ....................... -~~ PLOT DIAGRAM ' ~ Loca.t~'L'~ar_ly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from , pr~:s~.~i.V_eorttr, e.e~t_tand block number or description according to deed, and show street names and nd cate STATE OF NEW~(ORI~,_, ~1/, t c c COUNTY. ................. L..,~,,~,.~I,4.~ .... ~,,.. ~,/~,~-~*; bei~ dul~ sworn, d~oses and says t~t he is the applicam (~me Of i~idual signing~ a~ve nom~. (Cont~tor, ag~t, co,rate ~ffJc~r, etc.) of said owner or owners, and is duly authorized to ~Orm or h~ performed the ~id work and to ~ke and file this application; that all statements contoin~; tn this a~l~ati~ are tme.t~the best of his knowledge and belief; and that the work will be performed in the manner ~t fo~h In the a~lication flied therewith. Swam to before me this · ..... .......... , ...................... ....... ............................................................... / ~ /(Signature of applicant) ~I~B~H ANN N~ILL~ / / ~ARY PU~IC, SMte of N~ YO~ No. 52-8125850, Suffolk County. Term Expires March 30. 19~